Abstract
A woman aged 76 years old with primary lung cancer underwent thoracoscopic surgery for right upper lobectomy with lymph node dissection. After extubation, poor oxygenation and auscultatory findings of bronchial stenosis were observed. CT revealed atelectasis of the right middle lobe and partial atelectasis of the right lower lobe. Bronchoscopy revealed narrowing of the intermediate bronchial trunk and obstruction of the middle lobe bronchus. A second operation was performed 9 days after the initial surgery. Operative findings showed that the middle lobe was displaced in the cranial direction. To prevent further displacement of the remaining middle lobe in the cranial direction, we created a septum in the thoracic cavity with a polytetrafluoroethylene sheet (ePTFE sheet) under thoracoscopy. No bronchial stenosis was apparent postoperatively, and the patient was discharged from hospital 12 days after the second operation. It is likely that the displacement of the remaining middle lobe in the cranial direction caused the intermediate bronchial trunk to be bent inward.
